For women who experience a miscarriage or ectopic pregnancy, the emotional anguish can linger.
While many have long understood that pregnancy loss comes with overwhelming emotions, a new study in the American Journal of Obstetrics and Gynecology reinforces what was suspected: Women who have an early miscarriage or ectopic pregnancy are more likely to experience post-traumatic stress disorder, anxiety and depression.
“This article brings awareness to the psychological components of ectopic pregnancy and miscarriage,” Dr. Christine Greves, an OB-GYN at Orlando Health Winnie Palmer Hospital for Women and Babies, in Orlando, Florida, told TODAY Parents. “Every patient is different. For some, a miscarriage is a loss of a dream, a loss of the potential name, a loss of a promise and some women have a (loss of) self-identity.”
Researchers from Imperial College in London and KU Leuven in Belgium asked 650 women — who either experienced a miscarriage before 12 weeks or an ectopic pregnancy, where the embryo grows outside the uterus — to fill out standardized surveys assessing their mental health at one, three and nine months after their loss.
One month following a loss, 29% of women experienced PTSD while 24% experienced moderate to severe anxiety and 11% experienced moderate to severe depression. When asked at nine months, those numbers dropped to 18% with PTSD, 17% with anxiety and 6% with depression.
“There are large numbers of women who suffer early pregnancy loss,” Dr. Priya Gopalan, chief of psychiatry at UPMC Magee Womens Hospital in Pittsburgh, who did not participate in the research, told TODAY Parents. “There is a grieving process that goes along with it and for some women that becomes pathological, it becomes PTSD level.”
While the results aren’t surprising to many, the paper is one of the first to examine impact early pregnancy loss and ectopic pregnancy has on women's mental health.
“What this study really highlights is just the extent of how much the suffering goes on. This is not just grief. It's like grief plus,” Gopalan said. “I don't think that we have ever had much research on PTSD and anxiety in this context, period.”
Gopalan says that in recent years medical professionals have become much better at identifying postpartum depression and anxiety in patients, thanks in part to screening from their doctors and their babies’ pediatricians. This paper indicates that experts might need to expand screening for women’s mental health to include miscarriage, ectopic pregnancy and stillbirths.
“We need to be a little bit more proactive to try to help women who may potentially struggle for months after a loss,” Gopalan said. “PTSD is such a debilitating thing that I would argue that any amount of time with the symptoms is actually pretty impairing.”
Women with PTSD are more likely to have physical health problems, such as increased blood pressure or more pain, as well as a higher chance of depression and anxiety. And, Gopalan said that women who experience PTSD for more than six months are more likely to struggle with it throughout their lifetimes.
“We really do need to be doing more to support (women) who are struggling,” Gopalan said. "We really need to start talking as a society more broadly about women's mental health beyond postpartum depression."